DEBORA ROMEO BERTOLA
Projetos de Pesquisa
Unidades Organizacionais
Instituto da Criança, Hospital das Clínicas, Faculdade de Medicina - Médico
BIO, IB
LIM/36 - Laboratório de Pediatria Clínica, Hospital das Clínicas, Faculdade de Medicina
BIO, IB
LIM/36 - Laboratório de Pediatria Clínica, Hospital das Clínicas, Faculdade de Medicina
11 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 11
- Nationwide questionnaire data of 229 Williams-Beuren syndrome patients using WhatsApp tool(2021) PIRES, Lucas Vieira Lacerda; RIBEIRO, Rogerio Lemos; SOUSA, Adriana Modesto de; LINNENKAMP, Bianca Domit Werner; PONTES, Sue Ellen; TEIXEIRA, Maria Cristina Triguero Veloz; BEFI-LOPES, Debora Maria; HONJO, Rachel Sayuri; BERTOLA, Debora Romeo; KIM, Chong AeBackground: Williams-Beuren syndrome is a multisystemic disorder caused by a microdeletion of the 7q 11.23 region. Although familial cases with autosomal dominant inheritance have been reported, the vast majority are sporadic. Objective: To investigate the main complaints and clinical findings of patients with Williams-Beuren syndrome. Methods: A total of 757 parents of patients registered in the Brazilian Association of Williams-Beuren Syndrome (ABSW) received a questionnaire via WhatsApp from March to July 2017. Results: In total, 229 parents answered the survey. Age of diagnosis ranged from 2 days to 34 years (median: 3 years). The main clinical findings reported by the parents were abdominal colic (83.3%), failu re to thrive (71.5%), feeding difficulty in the first year (68.9%), otitis (56.6%), urinary tract infections (31.9%), precocious puberty (27.1%) and scoliosis (15.9%). Cardiac defects were present in 66% of patients, and the most frequent defect was supravalvular aortic stenosis (36%). Arterial hypertension was reported in 23%. Hypercalcemia was reported in 10.5% of patients, mainly during the first year of life. Hyperacusis and hypersociability were common complaints (both present in 89%). Other behavioral and neuropsychiatric symptoms reported by the parents included attention deficit (89%), anger crises (83%), excessive fear (66%), depression (64%), anxiety (67%) and hypersexuality(33%).The most common complaints were hypersensitivity to sounds, talkative personality, emotional dependence and learning difficulties. In 98.3%, the parents denied family history. Conclusions: Williams-Beuren syndrome requires close follow-up with different medical specialties due to their variable clinical comorbidities, including language and school learning difficulties, behavioral and psychiatric problems.
- Noonan syndrome patients beyond the obvious phenotype: A potential unfavorable metabolic profile(2021) NORONHA, Renata M.; VILLARES, Sandra M. F.; TORRES, Natalia; QUEDAS, Elisangela P. S.; HOMMA, Thais Kataoka; ALBUQUERQUE, Edoarda V. A.; MORAES, Michelle B.; FUNARI, Mariana F. A.; BERTOLA, Debora R.; JORGE, Alexander A. L.; MALAQUIAS, Alexsandra C.Noonan syndrome (NS) and NS related disorders (NRD) are frequent monogenic diseases. Pathogenic variants in PTPN11 are observed in approximately 50% of these NS patients. Several pleiotropic phenotypes have previously been described in this condition. This study aimed at characterizing glucose and lipid profiles in patients with NS/NRD. We assessed fasting blood glucose, insulin, cholesterol (total and fractions), and triglyceride (TG) levels in 112 prepubertal children and 73 adults. Additionally, an oral glucose tolerance test (OGTT) was performed in 40 children and 54 adults. Data were analyzed between age groups according to the presence (+) or absence (-) of PTPN11 mutation. Prepubertal patients with NS/NRD were also compared with a control group. Despite the lean phenotype of children with NS/NRD, they presented an increased frequency of low HDL-cholesterol (63% in PTPN11+, 59% in PTPN11- and 16% in control, p < .001) and high TG levels (29% in PTPN11+, 18% in PTPN11- and 2.3% in control). PTPN11+ patients had a higher median HOMA-IR (1.0, ranged from 0.3 to 3.2) in comparison with PTPN11- (0.6; 0.2 to 4.4) and controls (0.6; 0.4 to 1.4, p = .027). Impaired glucose tolerance was observed in 19% (10:54) of lean adults with NS/NRD assessed by OGTT. Moreover, women with PTPN11 mutations had lower HDL-cholesterol levels than those without. Our results suggest that children and young adult patients with NS/NRD have an unfavorable metabolic profile characterized by low HDL, a tendency of elevated TGs, and glucose metabolism impairment despite a lean phenotype.
conferenceObject Characterization of puberty development in a large cohort of patients with Noonan syndrome with molecular diagnosis(2021) REZENDE, Raissa; JORGE, Alexander; NORONHA, Renata; KESELMAN, Ana; ANDRADE, Nathalia; DANTAS, Naiara; BERTOLA, Debora; MALAQUIAS, Alexsandra- Congenital limb deficiency: Genetic investigation of 44 individuals presenting mainly longitudinal defects in isolated or syndromic forms(2021) ROCHA, Leticia Alves da; PIRES, Lucas Vieira Lacerda; YAMAMOTO, Guilherme Lopes; CERONI, Jose Ricardo Magliocco; HONJO, Rachel Sayuri; BISNETO, Edgard de Novaes Franca; OLIVEIRA, Luiz Antonio Nunes; ROSENBERG, Carla; KREPISCHI, Ana Cristina Victorino; PASSOS-BUENO, Maria Rita; KIM, Chong Ae; BERTOLA, Debora RomeoCongenital limb deficiency (CLD), one of the most common congenital anomalies, is characterized by hypoplasia/aplasia of one or more limb bones and can be isolated or syndromic. The etiology in CLD is heterogeneous, including environmental and genetic factors. A fraction remains with no etiological factor identified. We report the study of 44 Brazilian individuals presenting isolated or syndromic CLD, mainly with longitudinal defects. Genetic investigation included particularly next-generation sequencing (NGS) and/or chromosomal microarray. The overall diagnostic yield was 45.7%, ranging from 60.9% in the syndromic to 16.7% in the non-syndromic group. In TAR syndrome, a common variant in 3 ' UTR of RBM8A, in trans with 1q21.1 microdeletion, was detected, corroborating the importance of this recently reported variant in individuals of African ancestry. NGS established a diagnosis in three individuals in syndromes recently reported or still under delineation (an acrofacial dysostosis, Coats plus and Verheij syndromes), suggesting a broader phenotypic spectrum in these disorders. Although a low rate of molecular detection in non-syndromic forms was observed, it is still possible that variants in non-coding regions and small CNVs, not detected by the techniques applied in this study, could play a role in the etiology of CLD.
- Cerebellofaciodental syndrome in an adult patient: Expanding the phenotypic and natural history characteristics(2021) HONJO, Rachel Sayuri; CASTRO, Matheus Augusto Araujo; FERRACIOLLI, Suely Fazio; SOARES JUNIOR, Luiz Alberto Valente; PASTORINO, Antonio Carlos; BERTOLA, Debora Romeo; MIYAKE, Noriko; MATSUMOTO, Naomichi; KIM, Chong AeCerebellofaciodental syndrome is characterized by facial dysmorphisms, intellectual disability, cerebellar hypoplasia, and dental anomalies. It is an autosomal-recessive condition described in 2015 caused by pathogenic variants in BRF1. Here, we report a Brazilian patient who faced a diagnostic challenge beginning at 11 months of age. Fortunately, whole-exome sequencing (WES) was performed, detecting the BRF1 variants NM_001519.3:c.1649delG:p.(Gly550Alafs*36) and c.421C>T:p.(Arg141Cys) in compound heterozygosity, thus finally achieving a diagnosis of cerebellofaciodental syndrome. The patient is currently 25 years old and is the oldest patient yet reported. The clinical report and a review of published cases are presented. Atlanto-occipital fusion, a reduced foramen magnum and basilar invagination leading to compression of the medulla-spinal cord transition are skeletal findings not reported in previous cases. The description of syndromes with dental findings shows that such anomalies can be an important clue to relevant differential diagnoses. The cooperation of groups from different international centers made possible the resolution of this and other cases and is one of the strategies to bring medical advances to developing countries, where many patients with rare diseases are difficult to diagnose definitively.
- SCUBE3 loss-of-function causes a recognizable recessive developmental disorder due to defective bone morphogenetic protein signaling(2021) LIN, Yuh-Charn; NICETA, Marcello; MUTO, Valentina; VONA, Barbara; PAGNAMENTA, Alistair T.; MAROOFIAN, Reza; BEETZ, Christian; DUYVENVOORDE, Hermine van; DENTICI, Maria Lisa; LAUFFER, Peter; VALLIAN, Sadeq; CIOLFI, Andrea; PIZZI, Simone; BAUER, Peter; GRUENING, Nana-Maria; BELLACCHIO, Emanuele; FATTORE, Andrea Del; PETRINI, Stefania; SHAHEEN, Ranad; TIOSANO, Dov; HALLOUN, Rana; Ben Pode-Shakked; ALBAYRAK, Hatice Mutlu; ISIK, Emreguel; WIT, Jan M.; DITTRICH, Marcus; FREIRE, Bruna L.; BERTOLA, Debora R.; JORGE, Alexander A. L.; BAREL, Ortal; SABIR, Ataf H.; TENAIJI, Amal M. J. Al; TAJI, Sulaima M.; AL-SANNAA, Nouriya; AL-ABDULWAHED, Hind; DIGILIO, Maria Cristina; IRVING, Melita; ANIKSTER, Yair; BHAVANI, Gandham S. L.; GIRISHA, Katta M.; HAAF, Thomas; TAYLOR, Jenny C.; DALLAPICCOLA, Bruno; ALKURAYA, Fowzan S.; YANG, Ruey-Bing; TARTAGLIA, MarcoSignal peptide-CUB-EGF domain-containing protein 3 (SCUBE3) is a member of a small family of multifunctional cell surface-anchored glycoproteins functioning as co-receptors for a variety of growth factors. Here we report that bi-allelic inactivating variants in SCUBE3 have pleiotropic consequences on development and cause a previously unrecognized syndromic disorder. Eighteen affected individuals from nine unrelated families showed a consistent phenotype characterized by reduced growth, skeletal features, distinctive craniofacial appearance, and dental anomalies. In vitro functional validation studies demonstrated a variable impact of disease-causing variants on transcript processing, protein secretion and function, and their dysregulating effect on bone morphogenetic protein (BMP) signaling. We show that SCUBE3 acts as a BMP2/BMP4 co-receptor, recruits the BMP receptor complexes into raft microdomains, and positively modulates signaling possibly by augmenting the specific interactions between BMPs and BMP type I receptors. Scube3(-/-) mice showed craniofacial and dental defects, reduced body size, and defective endochondral bone growth due to impaired BMP-mediated chondrogenesis and osteogenesis, recapitulating the human disorder. Our findings identify a human disease caused by defective function of a member of the SCUBE family, and link SCUBE3 to processes controlling growth, morphogenesis, and bone and teeth development through modulation of BMP signaling.
- Atypical, severe hypertrophic cardiomyopathy in a newborn presenting Noonan syndrome harboring a recurrent heterozygous MRAS variant(2021) PIRES, Lucas Vieira Lacerda; BORDIM, Renata de Almeida; MACIEL, Maria Beatriz Rabelo; TANAKA, Ana Cristina Sayuri; YAMAMOTO, Guilherme Lopes; HONJO, Rachel Sayuri; KIM, Chong Ae; BERTOLA, Debora RomeoNoonan syndrome (NS) is a Mendelian phenotype, member of a group of disorders sharing neurocardiofaciocutaneous involvement, known as RASopathies, caused by germline variants in genes coding for components of the RAS/MAPK signaling pathway. Recently, a novel gene of the RAS family (MRAS) was reported to be associated with NS in five children, all of them presenting, among the cardinal features of NS, the same cardiac finding, hypertrophic cardiomyopathy (HCM). We report on a 2-month-old infant boy also presenting this cardiac anomaly that evolved to a fatal outcome after a surgical myectomy. In addition, a thick walled left ventricle apical aneurysm, rarely described in NS, was also disclosed. Next-generation sequencing revealed a missense, previously reported variant in MRAS (p.Thr68Ile). This report reinforces the high frequency of HCM among individuals harboring MRAS variants, contrasting to the 20% overall prevalence of this cardiac anomaly in NS. Thus, these preliminary data suggest that variants in MRAS per se are high risk factors for the development of an early, severe HCM, mostly of them with left ventricle outflow tract obstruction, with poor prognosis. Because of the severity of the cardiac involvement, other clinical findings could not be addressed in detail. Therefore, long-term follow-up of these individuals and further descriptions are required to fully understand the complete phenotypic spectrum of NS associated with MRAS germline variants, including if these individuals present an increased risk for cancer.
- Efficient detection of copy-number variations using exome data: Batch- and sex-based analyses(2021) UCHIYAMA, Yuri; YAMAGUCHI, Daisuke; IWAMA, Kazuhiro; MIYATAKE, Satoko; HAMANAKA, Kohei; TSUCHIDA, Naomi; AOI, Hiromi; AZUMA, Yoshiteru; ITAI, Toshiyuki; SAIDA, Ken; FUKUDA, Hiromi; SEKIGUCHI, Futoshi; SAKAGUCHI, Tomohiro; LEI, Ming; OHORI, Sachiko; SAKAMOTO, Masamune; KATO, Mitsuhiro; KOIKE, Takayoshi; TAKAHASHI, Yukitoshi; TANDA, Koichi; HYODO, Yuki; HONJO, Rachel S.; BERTOLA, Debora Romeo; KIM, Chong Ae; GOTO, Masahide; OKAZAKI, Tetsuya; YAMADA, Hiroyuki; MAEGAKI, Yoshihiro; OSAKA, Hitoshi; NGU, Lock-Hock; SIEW, Ch'ng G.; TEIK, Keng W.; AKASAKA, Manami; DOI, Hiroshi; TANAKA, Fumiaki; GOTO, Tomohide; GUO, Long; IKEGAWA, Shiro; HAGINOYA, Kazuhiro; HANIFFA, Muzhirah; HIRAISHI, Nozomi; HIRAKI, Yoko; IKEMOTO, Satoru; DAIDA, Atsuro; HAMANO, Shin-ichiro; MIURA, Masaki; ISHIYAMA, Akihiko; KAWANO, Osamu; KONDO, Akane; MATSUMOTO, Hiroshi; OKAMOTO, Nobuhiko; OKANISHI, Tohru; OYOSHI, Yukimi; TAKESHITA, Eri; SUZUKI, Toshifumi; OGAWA, Yoshiyuki; HANDA, Hiroshi; MIYAZONO, Yayoi; KOSHIMIZU, Eriko; FUJITA, Atsushi; TAKATA, Atsushi; MIYAKE, Noriko; MIZUGUCHI, Takeshi; MATSUMOTO, NaomichiMany algorithms to detect copy number variations (CNVs) using exome sequencing (ES) data have been reported and evaluated on their sensitivity and specificity, reproducibility, and precision. However, operational optimization of such algorithms for a better performance has not been fully addressed. ES of 1199 samples including 763 patients with different disease profiles was performed. ES data were analyzed to detect CNVs by both the eXome Hidden Markov Model (XHMM) and modified Nord's method. To efficiently detect rare CNVs, we aimed to decrease sequencing biases by analyzing, at the same time, the data of all unrelated samples sequenced in the same flow cell as a batch, and to eliminate sex effects of X-linked CNVs by analyzing female and male sequences separately. We also applied several filtering steps for more efficient CNV selection. The average number of CNVs detected in one sample was <5. This optimization together with targeted CNV analysis by Nord's method identified pathogenic/likely pathogenic CNVs in 34 patients (4.5%, 34/763). In particular, among 142 patients with epilepsy, the current protocol detected clinically relevant CNVs in 19 (13.4%) patients, whereas the previous protocol identified them in only 14 (9.9%) patients. Thus, this batch-based XHMM analysis efficiently selected rare pathogenic CNVs in genetic diseases.
conferenceObject Novel LZTR1 mutations in subjects with features of Noonan Syndrome and GH insensitivity negatively regulate GH-induced IGF-I production and hyperactivate GH-induced ERK1/2 activation in response to GH in vitro(2021) CHATTERJEE, Sumana; BERTOLA, Debora Romeo; AGWU, Chizo; MAHARAJ, Avinaash; WILLIAMS, Jack; COTTRELL, Emily; SHAPIRO, Lucy; ANDREWS, Afiya; SAVAGE, Martin O.; GASTON-MASSUET, Carles; METHERELL, Louise A.; STORR, Helen L.- Twenty-year follow-up of the facial phenotype of Brazilian patients with Sotos syndrome(2021) CASTRO, Matheus Augusto Araujo; SANTOS, Juliana Heather Vedovato dos; HONJO, Rachel Sayuri; YAMAMOTO, Guilherme Lopes; BERTOLA, Debora Romeo; HURST, Anna C.; CHORICH, Lynn P.; LAYMAN, Lawrence C.; KIM, Chong Ae; KIM, Hyung-GooSotos syndrome is characterized by overgrowth starting before birth through childhood with intellectual disability and craniofacial anomalies. The majority of patients are large for gestational age with developmental delay or intellectual disability. The majority of cases are caused by pathogenic variants in NSD1. The most consistent physical features in this disorder are facial dysmorphisms including prominent forehead, downslanted palpebral fissures, prognathism with a pointed chin, and a long and narrow face. We present a follow-up to a cohort of 11 individuals found to harbor heterozygous, pathogenic, or likely pathogenic variants in NSD1. We analyzed the facial dysmorphisms and the condition using retrospective over 20 years. Among these patients, followed in our medical genetics outpatient clinic for variable periods of time, all had a phenotype compatible with the characteristic Sotos syndrome facial features, which evolved with time and became superimposed with natural aging modifications. We present here a long-term follow-up of facial features of Brazilian patients with molecularly confirmed Sotos syndrome. In this largest Brazilian cohort of molecularly confirmed patients with Sotos syndrome to date, we provide a careful description of the facial phenotype, which becomes less pronounced with aging and possibly more difficult to recognize in adults. These results may have broad clinical implications for diagnosis and add to the global clinical delineation of this condition.